Submit Bulk Juice or Wine

Winery Name: *
Your WSMP number:
Wine Variety: *	--- Select one --- - Albarino Arneis Blended Reds Blended Whites Breidecker Cabernet Franc Cabernet Franc Blends Cabernet Merlot Blend Cabernet Sauvignon Cabernet Sauvignon Blends Chardonnay Chenin Blanc Dessert (Sweet) Wine Dry Red Dry White Gewurztraminer Gruner Veltliner Malbec Malbec Blends Merlot Merlot Blends Montepulciano Muscat Műller Thurgau New Variety Palomino Petit Verdot Pinot Blanc Pinot Gris Pinot Meunier Pinot Noir Pinotage Port Reichensteiner Riesling Rose / Rose Style Sangiovese Sauv Blanc / Semillon Blend Sauvignon Blanc Sauvignon Gris Semillon Sherry Sparkling or Methode Style St Laurent Syrah Blends Syrah/Shiraz Tempranillo Verdello Viognier Zinfandel *** Other *** Please specify:
Country of Origin: *	Australia China New Zealand South Africa United Kingdom United States *** Other *** Please specify:
Your Wine Code:	eg. Batch Number or Tank Number
Vintage: *
Price per Litre: $	Inclusive of Wine Network's Commission
Volume Available: *	Litres (Please enter numbers only)
What would be the minimum volume you would consider selling per transaction? *
Total Volume  Other  (Please enter numbers only)

GRAPES * (Use the buttons on the right to add or remove rows as necessary.)

Vintage *	Varieties *	Region *	District	Clone	Percentage *
					%
nb: Total must equal 100%				Total:	0%

---

Region Wine is located: * --- Select one --- Argentina Auckland Australia - South East Australia - Victoria Bay of Plenty Canterbury Central Otago China Cromwell East Coast Gisborne Hastings Hawke's Bay Horowhenua Marlborough Martinborough Masterton Matakana Nelson New Zealand North Island North Waikato Northland Other - Outside New Zealand South Africa - Western Cape South Island United Kingdom United States Various Waiheke Island Waikato Waipara Wairarapa Waitaki Valley Wellington West Auckland *** Other ***

Processing / storage facility name: (not to be published on the website, for Wine Network information only)

The Product is Available as: * Cold Settled Juice Cloudy Wine Cellar Bright Finished Wine Options:* Clear juice Other (please specify) Options:* Racked on light lees Twice racked and sulphured Protein stable Other (please specify) Options:* Sugar been added post fermentation Concentrate been added post fermentation Bottle Ready NTU < 1 Protein stable Cold Stable Other (please specify)

Wine Analysis --- TA: g/L    pH:    RS: g/L    VA: g/L   Alc/Vol:  %

Grapes at Harvest --- Brix:    TA: g/L    pH:

---

	Yes	No	Unsure
Spray Diary can be provided? *
Wine composition report detailing additives can be provided? *
Current Auditors Report can be supplied? *
Do you comply with New Zealand Winegrowers Wine Standards Management Plan Code of Practise? *
Certified Organic Vineyard? *
Certified Organic Wine? *
BioGro Certified Winery? *
Sustainable Winegrowing NZ Recognised Vineyard? *
Sustainable Winegrowing NZ Recognised Winery? *

---

	Yes	No	Unsure
Has an Export Spray Programme been followed? *
Has the Wine been Multi-Residue Spray tested? *
Has the Wine been Export Approved? *
	SC # Expiry?
Does the Wine meet EU Eligibility? *
Does the Wine meet UK Eligibility? *
Have genetically modified/engineered substances been used? *

---

Suitable For
Vegetarians *	Yes	No	Unsure
Vegans *	Yes	No	Unsure
Coeliacs *	Yes	No	Unsure

---

	Yes	No
Is the Wine available for sale now?			If No, when?
Is the Wine listed with anyone else?			If YES, please list?
Has the Wine been offered to anyone else?			If YES, please list?

---

TREATMENT	If YES please state percentage
Stainless Steel Fermentation	Yes	No	%
Barrel Fermented	Yes	No	%
Barrel Aged	Yes	No	%
Chipped	Yes	No	%
Beans	Yes	No	%
Staved	Yes	No	%
Time in Oak	Days Months

---

WINEMAKING
Malolactic Fermentation	Yes	No	%
Protein Stabilised	Yes	No
Cold Stabilised	Yes	No	If YES, Please select: Refrigeration Stars/ED CMC
Sitting on Lees	Yes	No
Centrifuged	Yes	No
Earth Filtration	Yes	No	Type:
Pad Filter	Yes	No	If YES, Pad size?
Filtration Completed	Yes	No	Type:

---

This information is not published on the website, for Wine Networks internal and promotional use only

CURRENT PRODUCTION CERTIFICATES

---

This information is not published on the website, for Wine Networks internal and promotional use only

Style Description	Quality Level	Red Wine Info
Light Bodied Aromatic Crisp Dry Fruity Medium bodied Mellow Soft Smooth Full bodied Rich Oaky (please tick as many as you feel relevant for this parcel)	Super Premium Premium Mid Tier Commercial Entry Level	1 2 3 4 5 6 7 8 9 10 (Colour Scale 1-10, 1 being light, 10 being very dark.)

---

Unique Selling Points to help promote your listing (eg. Single vineyard, independent wine review, organic, quality information, etc):

---

Completed By: *
First name: *
Last name: *
Position: *
Email Address: *
Contact Number: *

---

Contact for Sample Requests and Reviews		Contact for Offers
(Same as above? )		(Same as above? )
First name: *		First name: *
Last name: *		Last name: *
Position: *		Position: *
Email: *		Email: *
Phone: *		Phone: *

I agree that all the information supplied in this form is true and correct and that Wine Network NZ Limited may disclose this information for the purpose of On-Sale as a wine broker on our behalf.